Tim Mitchell Medical, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

TIM MITCHELL MEDICAL, INC

Doing business as

Mitchell's Downtown Drug Store

Practice address

115 E Hickory St
Neosho, MO 64850-1806

Phone

(417) 451-3776

Fax

(417) 451-2332

NPI assigned

Sep 13, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Tim Mitchell, R.PH.

Title

Owner/President

Phone

(417) 451-3776

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mitchell's Downtown Drug Store Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Tim Mitchell Medical, Inc

  • Community/Retail Pharmacy
  • Neosho, MO
  • NPI 1316041353

  O20191204000110

  Same enrollment
• Tim Mitchell Medical, Inc

  • Community/Retail Pharmacy
  • Neosho, MO
  • NPI 1578669701

  O20191204000110

  Same enrollment

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Tim Mitchell Medical, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Neosho, MO
  • NPI 1952440422

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1184059784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 S NEOSHO BLVD",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648502051",
            "telephone_number": "417-455-1883",
            "fax_number": "417-455-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E HICKORY ST",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648501806",
            "telephone_number": "417-451-3776",
            "fax_number": "417-451-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIM MITCHELL MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "417-451-3776",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600003470",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mitchell's Downtown Drug Store",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mitchell's Downtown Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Talley Chiropractic Offices, P.C.
• Patricia Arlene Thompson, DC
• Tim Mitchell Medical Inc
• Tim Mitchell Medical Inc
• Tim Mitchell Medical Inc
• Tim Mitchell Medical, Inc
• Tim Mitchell Medical, Inc
• Tim Mitchell Medical, Inc
• Tim Mitchell Medical, Inc
• Tim Mitchell Medical, Inc.

• Community/Retail Pharmacy in Neosho, MO
• Providers in Neosho, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.